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Duke Economist to NC Lawmakers: APRNs Can Save NC Billions

Duke health economist Chris Conover testifies before the Joint Health and Human Services Overview Committee.


RALEIGH, N.C. - Feb. 9, 2016 - During a presentation to North Carolina legislators Tuesday morning, Dr. Chris Conover, a health economist at Duke University, explained that Advanced Practice Registered Nurses (APRNs) are being underutilized due to restrictive regulations. Conover spoke to the Joint Health and Human Services Oversight Committee about his 2015 research showing that APRNs have the potential to improve quality and access to healthcare while saving between $433 million and $4.3 billion per year in North Carolina.

“Modernizing North Carolina’s regulation of APRNs would allow North Carolina residents to enjoy better access to care of equivalent or better quality even as the health system sheds some avoidable costs in the process,” Conover said.

Senate Bill  695/House Bill 807 Modernize Nursing Practice Act, which is currently working its way through the General Assembly, would reduce regulations and allow full practice authority for APRNs.

Conover’s conservative estimates conclude that expanding the use of APRNs would save North Carolina more than $430 million annually in health care costs while adding at least 3,800 jobs to the economy.

“Our nurses are our best source of practitioners in our rural areas,” Senator Ralph Hise (R-Mitchell) said. “You want the most likelihood of someone practicing in a rural area? It’s someone who attends a community college in a nursing program and even goes on to higher degrees that is most likely to serve in a rural area.”

APRNs are some of the most highly-trained nurses in the profession, and require masters-level education. The four types of APRNs include:

  • Nurse Practitioners
  • Certified Nurse-Midwives
  • Certified Registered Nurse Anesthetists
  • Clinical Nurse Specialists

Currently, most APRNs in North Carolina are forced to sign agreements with “supervising physicians” in order to practice; these contracts can often be costly and do not require the physician to actually oversee patient care.

“Opponents to the improvements addressed in the Modernize Nursing Practice Act will invariably say there are safety concerns. It is the only argument they ever bring forth, but it is an argument that holds no water,” said NCNA President Mary Graff, MSN, RN, NEA-BC. “Nursing is the most trusted profession in the country, but opponents to this bill imply that nurses can’t be trusted to practice to the full scope of their training and education. That simply doesn’t add up.”

Primary sponsors of Senate Bill 695 include Senator Hise and Senator Louis Pate (R-Wayne). Primary sponsors of House Bill 807 include Representative Marilyn Avila (R-Wake), Representative Donny Lambeth (R-Forsyth), Representative Sarah Stevens (R-Surry) and Representative Josh Dobson (R-McDowell).

For more information on Dr. Conover’s study through the Center for Health Policy & Inequalities Research at Duke University, visit